Honest Disagreements, But Crucial


UPDATE: After this post was published, we had a great discussion with Jason and Stephen Tweed, from Leading Home Care (still great people, whom we respect).  We moved from 99% agreement to 99.9%.  🙂

Stephen and Jason Tweed are very well-known figures in the home care industry, and rightly so.  They are bright, witty and very smart folks.  So, when we discovered a fundamental area of disagreement this week, we were very surprised.  But it is such an important area that we had a serious dialogue with them on the topic.  Some of that dialogue is reproduced, below, from our email exchanges.  We still think they are great and, even more, inspiring, but it is such an important topic that we want folks to see both perspectives.

So, what is this big question?  It is whether families who need in-home care should hire privately or hire an agency which employs Home Care Aides.  As you will see, we are in about 90% agreement.  The Tweeds believe that “most of the time families are much better served by hiring a home care company rather than trying to hire privately.”  Our own position is that “most of the time” is about 99%.

From our own family and professional experience, we feel so strongly about this that we have devoted a whole section of our Web site to the issue.  So, why do we have this basic disagreement?

Jason Tweed has actually hired caregivers privately, as his own employees.  He and his family have the experience in the industry to understand all of the issues specific to the home care industry, including workers compensation insurance codes, liability insurance, and so forth.

Our own experience, however, is that, unless a family has that level of knowledge, hiring privately or using an “independent contractor” is a disaster waiting to happen.

As we explained to Stephen and Jason Tweed,

[We] know of one case where caregivers were hired privately, through a family’s business. They paid workers comp, unemployment insurance, etc. Everything is good, right?  Not so much.  The family / business did not know to use the right workers comp code, so a claim blew up in their faces.  Not pretty.  A carrier may even choose to not cover employees if home care is outside the scope of the normal “business of the business.”

Other families have thought their home owners insurance would protect them, in terms of liability, only to have the insurance companies say, “Nope, that’s a domestic employee. You need business liability.  Home owners insurance does not cover.” 

The bottom line is that very few families – and even fewer senior clients without family resources – have the knowledge and resources to do everything right to protect themselves.

So, our wish for Jason and Stephen is, keep pushing the industry for higher quality and integrity.  We are with you 100%.  But when it comes to advising about hiring an agency versus a private caregiver, please make sure you are not counting on the family having your level of experience and knowledge of what needs to go right and what can go wrong.

Best wishes, Bert

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